Re: [HSF] Blood cardioplegia –St Thomas

[Prasanna Simha M]

The ration can still be maintained with the use of a double ampoule in 500
ml of Ringer that will mean that it gets diluted in 2 litres of blood which
is what needs to ultimately be done. The St thomas cardioplegia ampoule
needs to be dissolved in 1 litre of Ringer chloride classicaly and if you
are making a odification using blood then doubling th ampoules into 500 ml
(or 4 ampoules if you are using 1 litre bottles) gives the same K
concetration -6 mmol + 4mmol of K in Ringer chloride/lactate gives a final K
of 20 mEq/L and Mg of 16 mEq/L and 1 mmol/L of procaine. This is easier to
make and there is less chance of mistakes during mixing etc.We have been
using this mixture for years in our hospital for blood cardioplegia
delivery. When the ampoules were not available, we used to make it using
K,Mg and Lidocaine (as we did not have procaine).
Prasanna

On 9/18/07, yadav del <yadavluck at yahoo.com> wrote:
>
> The arresting agent in St thomas cardioplegia is  combination of  equal
> amounts of potassium  [16mol]and magnesium[16 mmol] rather than potassium
> alone.we can achieve manesium levels similar to that in st Thomas only by
> adding magnesium .
>
> psimha <prasannasimha at gmail.com> wrote:  Why is so much K being added ?
> That is not necessary if the correct
> mixture of blood to St Thomas solution is used. We do not add extra
> magenesium. Basically we add 2 Ampoules of St Thomas solution
> concentrate and add it to a bottle of Ringer, I also add 6 u of Insulin.
> This is given in a 1 part to 4 part blood via a bridge. Esmolol (0.5
> mg/Kg) and Adenosine 1 Ampoule is given as boluses and 50 mics NTG if
> the coronary resistance is high.
> Prasanna
> yadav del wrote:
> >
> > We use blood cardioplegia using St Thomas cardioplegia solution[Abbot
> laboratories] and blood in 1:4 ratio. We add extra potassium [90 meq/litre].
> We are not adding extra magnesium.
> > I wish to know about adding extra magnesium. What is the practice of
> others?
> >
> >
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-- 
Prasanna Simha M